[go: up one dir, main page]

WO2015140367A1 - Dispositif distracteur mécanique endocavitaire - Google Patents

Dispositif distracteur mécanique endocavitaire Download PDF

Info

Publication number
WO2015140367A1
WO2015140367A1 PCT/ES2015/000048 ES2015000048W WO2015140367A1 WO 2015140367 A1 WO2015140367 A1 WO 2015140367A1 ES 2015000048 W ES2015000048 W ES 2015000048W WO 2015140367 A1 WO2015140367 A1 WO 2015140367A1
Authority
WO
WIPO (PCT)
Prior art keywords
rods
transmission means
pivoting rods
rigid
driving gear
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/ES2015/000048
Other languages
English (en)
Spanish (es)
Inventor
José Ignagio RODRíGUEZ GARCÍA
Pablo SUÁREZ MÉNDEZ
José Manuel SIERRA VELASCO
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Universidad de Oviedo
Original Assignee
Universidad de Oviedo
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Universidad de Oviedo filed Critical Universidad de Oviedo
Publication of WO2015140367A1 publication Critical patent/WO2015140367A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/32—Devices for opening or enlarging the visual field, e.g. of a tube of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/31—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the rectum, e.g. proctoscopes, sigmoidoscopes, colonoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/0218—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00278—Transorgan operations, e.g. transgastric
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00818—Treatment of the gastro-intestinal system

Definitions

  • the present invention relates to an endocavitary mechanical actuator distractor device, formed by a system of pivoting rods, a head, an input port, transmission means for rotating the rods and actuation means that drive the transmission means. to unfold or retract the rods.
  • the invention provides a mechanical device that allows performing surgical procedures through natural orifices, such as Transanal Endoscopic Microsurgery (TEM), for medical examination, such as ultrasonography or gamma camera use, brachytherapy application, or dosing. of medications.
  • TEM Transanal Endoscopic Microsurgery
  • the device has a configuration that makes it suitable for use in several access routes, such as in the mentioned TEM or in diagnostic or therapeutic explorations or procedures of the urogenital area.
  • the invention is therefore applicable in the sectors in which devices are designed, produced and used for surgery, medical examination, or other sanitary or drug dosing therapies, such as in the technical sector of human or animal medicine. , that of machinery and mechanical equipment or that of chemistry and pharmacy.
  • TEM Transanal Endoscopic Microsurgery
  • the pneumo-rectum under pressure is associated with gas filling of the proximal colon. Part of the gas is lost when suction is used to eliminate the washing liquids and small hemorrhages that occur during the operation, as well as the aspiration of the fumes produced by cauterizing wounds with an electric and ultrasonic scalpel. Having to wait to recover the pressure inside the rectum every time it becomes necessary to aspirate is a problem that lengthens the duration considerably and makes the intervention more difficult, since the continuous aspirations cause the rectal space to collapse.
  • the pneumo-rectum requires general anesthesia and deep relaxation of the patient, which implies a series of inconveniences inherent to the anesthesia and the operation of the intervention, which partly depends on the tense state of the subject. The latter is especially relevant in fragile patients (elderly, with pluripatology, oncology ).
  • an elastic glove associated with some type of tube or accessory is simply used as a port that facilitates access to the interior of the subject or serves as a support for the instruments.
  • the glove opening is fixed around the port that is inserted into the patient's anus, thus achieving a tight seal.
  • the fingers of the gloves are pierced so that one presses C0 2 under pressure to open the field of vision in the area to be treated, and through the other perforated fingers of the glove, using trocar shirts typical of the approach laparoscopic, the camera, the light source and the instruments necessary for the intervention are introduced.
  • the present invention relates to a mechanical distracting device supporting surgical procedures, exploration or diagnostic-therapeutic procedures in which it is necessary to access the interior of the patient's body through a duct, and expand and maintain a workload in the cavity, which normally tends to collapse.
  • the invention preferably relates to Transanal Endoscopic Microsurgery (TEM) procedures
  • TEM Transanal Endoscopic Microsurgery
  • the device can also be applied more generically to other types of interventions, such as for examinations or diagnostic-therapeutic procedures, or to other parts anatomical as the urogynecological area, with the appropriate modifications if necessary.
  • an endocavitary mechanical distracting device comprising: - A set of rigid and pivoting rods at its ends when transmission means are actuated.
  • the rods have a curved and / or polygonal guideline, so that once pivoted they enable a free space as a work area within the patient's cavity.
  • the set of rods forms a means that expands the patient's duct, once the system has been introduced inside. In the moment before insertion, the rods are folded. When the system is introduced into the subject to the desired depth, the rods are pivoted by means of transmission. Because the guideline of the rods is not straight, their rotation expands the conduit in which they are located, enabling the workspace.
  • Rigid rods can have different distribution, shape, eccentricity and length depending on the needs of the intervention to be performed (remove tumor, make hemostasis, suture, etc.).
  • it is desirable to obtain a diaphanous work space as a reference of about 5 to 6 cm in diameter and between 12 and 20 cm long in the patient's body.
  • a front head that houses one of the ends of the pivoting rods.
  • This component in addition to housing one of the ends of the rods, serves as a facilitating means of penetration.
  • this front head has a conical and rounded shape so that it facilitates the introduction and removal of the device in the patient.
  • An inlet port that houses the other end of the pivoting rods and comprising a hole for access to the inside of the cavity.
  • the entrance port provides an access area inside the body with a fixed shape, maintaining a stable hole for the duration of the intervention.
  • the input port can also have specific fixings for the instruments.
  • a drive means of a transmission means allow the activation of the device by its operator.
  • Transmission means associated with one of the ends of the rigid and pivoting rods, which rotate the rods when actuating means are actuated.
  • the transmission means translate the activation order into the effective rotation of the rigid rods.
  • the entrance port comprises holes that line the perimeter of the access hole to the cavity, to fix the entrance port to the patient's body.
  • the position of the input port must be ensured, preventing its relative movement with respect to the subject.
  • These holes can be used for this purpose together with thread suture techniques or by using other fixing means, such as staples or screws.
  • the input port is detachable from the rigid rods, and also attachable to them. This technical feature is useful in some of the device's applications.
  • the foreign body that is introduced in this case the device of the invention
  • the head with the rods is first introduced, which makes the occupied volume small.
  • the input port or the other parts of the device are coupled, increasing the expansion of the conduit and / or the entrance.
  • the rods are pivoted, enabling the definitive workspace.
  • the above sequence is simply a example. The coupling or decoupling does not have to be done in any pre-established order, being normally at the discretion of the device operator.
  • the inlet port has pressure fittings radially arranged on its inner face, to fix the ends of the rods before or after they have been deployed inside the patient , and thus allow the necessary accessories (camera-point of light, surgical instruments, etc.) to pass inside.
  • the inlet port may not have the fittings for fixing the ends of the rods on its inner face, but simply have grooves on its outer face.
  • the transmission means are housed in the front head.
  • the transmission means are housed in the input port.
  • the front head can be of smaller size (length and diameter), allowing to take advantage of the space and its configuration to easily become an exploration camera holder, surgical tool holders or medication dosing holder.
  • the transmission means are decoupled from the input port or attachable to it. In this way the use of the apparatus is facilitated, using certain components only when they are necessary for a function, and clearing the entrance and the hole for access to the interior of the cavity.
  • the drive means of the transmission means comprise:
  • a transmission shaft that transmits a pair to the transmission means to pivot the set of rigid and pivoting rods.
  • the jacket when attached to the head and / or the input port, allows the rotation of the drive shaft while preventing uncontrolled torsion of the assembly when the rods are deployed, providing a fulcrum.
  • the drive means are decoupled or attachable to the rest of the device. Similar to previous cases, this allows the work space inside the visor and access to be released once the drive means have fulfilled their function.
  • the jacket in which the transmission shaft is housed can be coupled or uncoupled, ensuring the solidarity of the assembly by means of a removable threaded joint.
  • the drive means further comprise a knob associated with the drive shaft, which can be manually manipulated.
  • the torque that is transmitted to the rods and that cause their rotation may have their origin in the user's own manual action of the device.
  • its origin may be other motor means, such as electric motors, hydraulic or pneumatic drives, etc., in procedures such as TEM it is common for instruments to be controlled manually by the surgeon.
  • the transmission means comprise: - A driving or driving gear that transmits a pair to driven gears.
  • the driven gears are radially meshed around the driving gear.
  • the arrangement of the transmission means is such that the driving gear is located in the center and is radially surrounded by the driven gears, which are engaged therein.
  • the driving gear can be referred to as "planet” gear and the gears driven “satellite” gears.
  • the "satellite” gears, one per rod, are each fixed to one end of each rod, and are simultaneously driven by a “planet” gear, thus facilitating the rotation of the rods.
  • the torque that causes the movement of the "planet” gear reaches it through the drive shaft of the drive means, which can be coupled or uncoupled as required by the user.
  • the device further comprises flexible anti-collapse elements that perimetrically connect the pivoting rods.
  • the flexible anti-collapse elements act as a screen to keep the walls (intestinal, vaginal, etc.) between rods, away from the work area. This type of embodiment is advisable when the rods, once turned, are very separated or when the duct offers great resistance to opening, such as the rectal tract or the vagina.
  • the anti-collapse elements are threads. In another more specific embodiment, the anti-collapse elements are a network. In another more specific embodiment, the anti-collapse elements are bands or sheets.
  • One way of materializing the above specific embodiments is, for example, by means of transverse holes in the rods, through which the flexible anti-collapse elements (threads, elastic bands or others) can be placed.
  • a very important aspect of the invention is the fact that when opening the necessary work space for surgical interventions or explorations based on a mechanical system, it is not necessary to insufflate C0 2 (or other gas) under pressure, and avoid disadvantages of this technique due to the loss of pressure, which hinders and delays interventions.
  • interventions using the device of the invention can be done without the need for general anesthesia and deep relaxation of the patient.
  • the possibility therefore opens up of using less aggressive or dangerous intervention methods for the patient, such as with spinal anesthesia.
  • the device object of the invention also provides an expanded and stable working area during the entire period of time that the intervention lasts, due to the rigidity of the folding rods.
  • These elements constitute a stable screening structure against the natural tendency of collapse of patient access roads.
  • the deployment position of the rods can be maintained over time by interlocking the transmission means, if necessary.
  • the use of gears as means of Transmission allows a very high level of precision and repeatability, which results in safer interventions.
  • the folded rods once turned, are responsible for providing the necessary work space for a safe intervention.
  • These elements can be manufactured in different shapes and sizes, so that they can adapt both the length and the diameter of the device (both the minimum, with the rods folded to be introduced or removed from the patient's body, • as the maximum, which defines the workspace once expanded). Because they can be materialized in several ways, they can be adapted to specific procedures, such as scans, sutures, etc.
  • transmission means by gears drive means by means of a transmitter shaft and a knob for manual manipulation are described.
  • this embodiment assumes a very reliable and safe device.
  • the invention provides a device that, in addition to allowing the performance of surgery procedures, also provides a means for medical examination activities, medication dosing or other health therapies.
  • the invention is applicable in Transanal Endoscopic Microsurgery (TEM) procedures, but it also has a configuration that would make it suitable for other access routes, specifically in explorations or urogynecological surgeries.
  • TEM Transanal Endoscopic Microsurgery
  • the invention is therefore applicable in the sectors in which devices are designed, produced and used for surgery, medical exploration, other sanitary or drug dosing therapies, such as in the technical sector of human or animal medicine, that of machinery and mechanical equipment or that of chemistry and pharmacy. DESCRIPTION OF THE FIGURES
  • Fig. 1 shows a perspective view of the system, with the rods (6) in the retracted position.
  • Fig. 2 shows a perspective view of the system with the rods (6) in the deployed position.
  • Both the Fig. 1 and Fig. 2 show the same preferred embodiment of the device, which comprises several parts.
  • Head (1) Basically it is a piece that acts as a plug or closure for the transmission means (2) that are housed inside and that rotate the rods (6) with respect to their own axes.
  • the head (1) has a rounded outer shape that facilitates the introduction and removal of the device in the patient. It could be of a metallic material (and therefore reusable), or of a disposable plastic material.
  • Transmission media (2) Housed in a cylindrical part (carrier), with through holes through which the rods (6) are introduced.
  • the ends of these rods (6) are connected to driven gears (8) or "satellites”, which are actuated for rotation through another driving gear (7) or central "planet”, which Gear simultaneously with all driven gears (8) or “satellites” of the rods (6).
  • the transmission means (2) in these figures are hidden, covered by the carrier and the head itself (1).
  • Port of entry (3) It is a cylindrical piece at the back to which all the rods (6) are attached.
  • they are composed of a jacket (4) that houses a drive shaft (5) and a knob (9).
  • the jacket (4) that is represented is a complex and removable piece, composed of a tube with an outer thread in the front.
  • the jacket (4) can be attached to the carrier, keeping the position of the latter and the head (1) fixed, while allowing the relative rotation of the transmission shaft (5) that passes through its inside and induces the rotation of the driving gear (7) or central "planet".
  • the shirt is equipped with a handle with a knurled back that facilitates the grip of the set during its operation.
  • the drive means (10) also have a knob (9) on the back, which facilitates the fastening of the whole assembly both for its introduction, and for expanding or retracting the rods (6).
  • the drive shaft (5) is a straight rod.
  • a screwdriver-shaped head flat or star
  • a compatible head located on the driving gear shaft (7) or "planet.”
  • the knob (9) is located at one end of the drive means (10). This piece facilitates the rotation of the tool, as well as its introduction and removal.
  • Rods (6) They are curved shaped pieces. Its initial and final ends are aligned and straight, and have the central zone folded with a certain eccentricity. This eccentricity defines the free volume as a working area within the patient's cavity.
  • the shape of the fold, the angular distance between rods (6) and even the number of rods (6) could vary depending on the type of intervention to be carried out (remove a tumor, suture, perform scans with ultrasound devices , device probes for isotope identification, introduction of seeds for brachytherapy or others).
  • the rods (6) have spaced cross holes to accommodate flexible anti-collapse elements that perimetrically connect the rods (6). In these figures these elements are not represented.
  • the holes allow the use of an anti-collapse element in the form of a wire, which can be mounted on site, even by means of suture thread, and that allows the rods (6) to be joined transversely to each other, so that when they expand inside the intestine they serve as a screen or net to keep the work area free.
  • FIG. 3 A front view of the device without the head (1) is shown in Fig. 3. In it you can see a materialization of the transmission means (2), based on a gear mechanism that allows the simultaneous rotation of all the rods (6).
  • One end of each rod (6) is fixed to a driven gear (8) or "satellite” gear.
  • These "satellite” gears are in contact with a conductive gear (7) or “planet” gear which, when turned, drives the “satellite” gears that in turn rotate the rods (6), unfolding or folding them according to the direction of turn.
  • the entire assembly is covered by the head (1) so that the driving gear (7) or "planet” rotates around an axis between the head (1) and the drive carrier, as well as the driven gears ( 8) or “satellites".
  • the driving gear (7) or “planet” is in turn coupled to the drive shaft (5) of the drive means (10).
  • Fig. 4 the system can be seen in its two positions: folded and unfolded.
  • the outer diameter of the set D is determined by the diameter of the head (1).
  • the outer diameter of the assembly W is greater than D, and is determined by the space occupied by the deployed rods (6).
  • the diameter D is less than 3.5 cm, which facilitates the introduction or removal of the device in the patient's body.
  • the outer diameter W can reach 5 or 6 cm.
  • the lengths of the head (1) A and the inlet port (3) C are fixed, and the length of the rods (6) L can be adapted to the patient's size and tumor situation, varying between about 10 to 25 cm, if They could well be manufactured to any size.
  • the rear view of the device is shown in Fig. 5, when the rods (6) have been deployed in the working position, and with the rods (6) embedded in the inner perimeter of the input port (3).
  • a carrier that houses the transmission means (2), leaving a head in sight in the form of a star or cross located on the axis of the driving gear (7) or "planet" to which the transmission shaft (5) can be attached.
  • the drive means (10) are decoupled, leaving access to the interior of the cavity free.
  • Fig. 6 and in Fig. 7 a variant of the device is shown that allows to place uncoupling transmission means (2) in the rear part of the system, coupled in the input port (3). In this way, the transmission means (2) remain outside the patient's body, and the front of the device or head (1) is also left free.
  • the device described here was a mechanical system that, in folded or collected position, had an approximate outer diameter of 3 to 3.5 cm and with a rounded conical head (1), which facilitated that it could be introduced into the body of the patient by a natural route (anus or vagina).
  • a natural route anus or vagina.
  • some rods (6) that rotated with respect to their straight and aligned ends were expanded or deployed, leaving free within the patient's body a workspace, approximately cylindrical, with a diameter of between 5 and 6 cm and a length of 8 cm.
  • the transmission means (2) materialized in gears: a driving gear (7) or “planet” and five driven gears (8) or “satellites", each of them fixed to the end of one of the rods (6).
  • the drive means (10) consisted of two parts: a jacket (4) and a drive shaft (5).
  • the drive shaft (5) had a star-shaped or double-spindle machining at the end, which in turn acted directly on a compatible head on the driving gear shaft (7) or "planet” for the rotation of the rods. (6), thus allowing to deploy or retract these.
  • the drive shaft (5) ended at the end that was outside the distractor in a T-shaped knob (9).
  • one end of the rods (6) was introduced into a piece called the actuator holder, through a hole therein in which it rotated, by means of a friction bushing, the end of the rod (6).
  • the rod (6) was rigidly attached to a driven gear (8) called "satellite", with one for each rod (6).
  • the opposite end of the rods (6) was free, and once inside the patient's body and expanded the rods (6) to the working position, this free end that was still outside the patient's body was coupled by pressure to the piece called input port (3).
  • the coupling was made on the outer perimeter of the inlet port (3), thus leaving the hole for access to the interior of the cavity disposed in the inner part of the inlet port (3) free.
  • the transmission means (2) responsible for transmitting a torque for the rotation of the rods (6) with respect to their axes, were composed of six gears: five driven gears (8), called “satellites", around of a driving gear (7) "planet.”
  • the five driven gears (8) "satellites” (one for each rod carried by the distractor) were arranged radially inside a cylindrical part called a carrier, with the axes of the rods (6) and the driven gears (8) "satellites” located in the same circle.
  • the “satellites” gears were equal to each other (same module, number of teeth and primitive diameters), and simultaneously geared with a “planet” driving gear (7) located in the center of the drive-holder part and the circumference.
  • the driving gear shaft (7) "planet” rested on the one hand on the inside of the front head (1), and on the other hand on the center of the drive carrier.
  • the axis of this driving gear (7) "planet” had grooves in the front, so that it could be operated using coupling drive means (10) comprising a transmission shaft (5) with its machined head in the form of star or double planillo.
  • the drive means (10) were manual, and were formed by a drive shaft (5), a jacket (4) and a knob (9) at the end of the drive shaft.
  • the shirt (4) was manufactured from a round tube with a threaded end, while a knurled handle was inserted in the other that facilitated the grip.
  • the threaded end was inserted into the drive holder before inserting the device into the body cavity.
  • the device With the rods (6) in the stowed position, the device was introduced, placed and oriented by manipulating it with the shirt handle (4).
  • the drive shaft (5) was inserted into the jacket (4).
  • This drive shaft (5) had at one of its ends a drive knob (9) and on the other a star-shaped or double planar machining. When introduced through the jacket (4), it fit the corresponding star or groove shape in the shaft in which the driving gear (7) or "planet" was cut.
  • the device and its components can be manufactured with metallic materials (stainless steel, aluminum, etc.) and non-metallic materials (plastics, ABS, carbon fiber, etc.), which allows the whole set or parts of the system to be disposable or to undergo sterilization treatments to be reused.
  • the front head (1), the input port (3), the driving gear (7) “planet” and the driven gears (8) “satellites”, in addition to the knob (9), were made of ABS plastic. All the pieces were produced by additive manufacturing techniques using a 3D printer, which allowed to obtain pieces with adequate strength.
  • the rods (6) and the drive shaft (5) were made of AISI 316 stainless steel.
  • the jacket (4) was made of an aluminum tube, with one end attached to a hollow threaded piece of aluminum, which was used to fix the jacket (4) to the drive-holder piece.
  • a suitable glue was used for the materials to be joined, bi-component with high temperature resistance, so as to allow sterilization treatments.
  • the driving gear (7) "planet” and the driven gears (8) "satellites” were acquired from a commercial brand in stainless steel material (AISI 316).
  • the knob (9) was made of ABS plastic, obtained through additive manufacturing techniques.
  • the rods (6) and the drive shaft (5) were made of stainless steel (AISI 316).
  • the jacket (4) was made of an aluminum tube, with one end with a thread compatible with a threaded joint to fix the jacket (4) to the drive-holder part.
  • a third prototype was manufactured, which now incorporated the transmission means (2) not housed in the front head (1), but were coupled at the rear, in the input port (3). This allows to leave the front head (1) free, so that it can be used as an instrument holder, for a video camera, light source, medication dispenser or simply hollow with free access for observation or treatment of the area.
  • This variant was mainly characterized by the fact that the transmission means (2) were outside the patient's body.
  • the transmission means (2) were coupled and decoupled to the rods (6) by the back of the device, once the rods (6) exceeded the inlet port (3) outwards.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Gynecology & Obstetrics (AREA)
  • Pregnancy & Childbirth (AREA)
  • Reproductive Health (AREA)
  • Endoscopes (AREA)
  • Image Processing (AREA)
  • Processing Or Creating Images (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif distracteur mécanique endocavitaire comprenant un ensemble de tiges (6) rigides et pivotantes, une tête (1) avant, un port d'entrée (3), des moyens de transmission (2) et des moyens d'actionnement (10). Grâce à la configuration spéciale des tiges (6), après leur rotation, un espace de travail accessible par l'intermédiaire du port d'entrée (3) est formé. L'invention permet d'obtenir un dispositif d'appui dans des opérations de chirurgie, d'exploration médicale ou de dosage de médicaments, notamment en microchirurgie endoscopique transanale (TEM) ou dans des traitements uro-gynécologiques. L'invention trouve une application dans les secteurs dans lesquels on conçoit, produit et utilise des dispositif de chirurgie, d'exploration médicale ou de dosage de médicaments, comme par exemple dans le secteur technique de la médecine humaine ou vétérinaire, celui des machines et équipements mécaniques ou celui de la chimie et de la pharmacie.
PCT/ES2015/000048 2014-03-21 2015-03-20 Dispositif distracteur mécanique endocavitaire Ceased WO2015140367A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ESP201400240 2014-03-21
ES201400240A ES2503891B2 (es) 2014-03-21 2014-03-21 Dispositivo distractor mecánico endocavitario

Publications (1)

Publication Number Publication Date
WO2015140367A1 true WO2015140367A1 (fr) 2015-09-24

Family

ID=51627887

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/ES2015/000048 Ceased WO2015140367A1 (fr) 2014-03-21 2015-03-20 Dispositif distracteur mécanique endocavitaire

Country Status (2)

Country Link
ES (1) ES2503891B2 (fr)
WO (1) WO2015140367A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107080516A (zh) * 2017-05-28 2017-08-22 苏州乐步生物科技有限公司 一种肛肠检查装置
WO2023052958A1 (fr) * 2021-09-29 2023-04-06 Cilag Gmbh International Systèmes d'ancrage chirurgical pour accès endoluminal
US12478363B2 (en) 2021-09-29 2025-11-25 Cilag Gmbh International Surgical systems with intraluminal and extraluminal cooperative instruments
US12484889B2 (en) 2021-10-01 2025-12-02 Cilag Gmbh International Surgical anchoring systems for endoluminal access

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3517128A (en) * 1968-02-08 1970-06-23 James R Hines Surgical expanding arm dilator
US5197971A (en) * 1990-03-02 1993-03-30 Bonutti Peter M Arthroscopic retractor and method of using the same
DE4318950C1 (de) * 1993-05-25 1994-09-29 Ethicon Endo Surgery Europe Gewebespreizvorrichtung
US5803902A (en) * 1994-10-06 1998-09-08 United States Surgical Corporation Surgical retractor
WO2000007504A1 (fr) * 1998-08-06 2000-02-17 Biomed, S.A. Instrument de separation d'organes, de tissus et/ou de visceres
WO2005000111A1 (fr) * 2003-06-26 2005-01-06 University Of Dundee Extenseur rectal
WO2011128622A1 (fr) * 2010-04-13 2011-10-20 Central Manchester University Hospitals Nhs Foundation Trust Dispositif et procédés chirurgicaux

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3517128A (en) * 1968-02-08 1970-06-23 James R Hines Surgical expanding arm dilator
US5197971A (en) * 1990-03-02 1993-03-30 Bonutti Peter M Arthroscopic retractor and method of using the same
DE4318950C1 (de) * 1993-05-25 1994-09-29 Ethicon Endo Surgery Europe Gewebespreizvorrichtung
US5803902A (en) * 1994-10-06 1998-09-08 United States Surgical Corporation Surgical retractor
WO2000007504A1 (fr) * 1998-08-06 2000-02-17 Biomed, S.A. Instrument de separation d'organes, de tissus et/ou de visceres
WO2005000111A1 (fr) * 2003-06-26 2005-01-06 University Of Dundee Extenseur rectal
WO2011128622A1 (fr) * 2010-04-13 2011-10-20 Central Manchester University Hospitals Nhs Foundation Trust Dispositif et procédés chirurgicaux

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107080516A (zh) * 2017-05-28 2017-08-22 苏州乐步生物科技有限公司 一种肛肠检查装置
WO2023052958A1 (fr) * 2021-09-29 2023-04-06 Cilag Gmbh International Systèmes d'ancrage chirurgical pour accès endoluminal
US12478363B2 (en) 2021-09-29 2025-11-25 Cilag Gmbh International Surgical systems with intraluminal and extraluminal cooperative instruments
US12484889B2 (en) 2021-10-01 2025-12-02 Cilag Gmbh International Surgical anchoring systems for endoluminal access

Also Published As

Publication number Publication date
ES2503891B2 (es) 2015-04-13
ES2503891A1 (es) 2014-10-07

Similar Documents

Publication Publication Date Title
US7771384B2 (en) Trocar with integral irrigation and suction tube
ES2639017T3 (es) Puerto de acceso multi lumen
ES2953466T3 (es) Entrada asistida visualmente de una aguja de Veress con un videoscopio cónico para microlaparoscopia
ES2306309T3 (es) Obturador optico.
US6908427B2 (en) Flexible endoscope capsule
US10758273B2 (en) Uterine manipulator device with cutting element
JP3805826B2 (ja) 手術用解剖器具
ES2687119T3 (es) Dispositivo de extirpación de tejido con elevada velocidad de movimiento de vaivén
US5855549A (en) Method of using an optical female urethroscope
ES2643464T3 (es) Elemento electroquirúrgico y manipulador uterino para histerectomía laparoscópica total
ES2774747T3 (es) Aparato para histeroscopia y biopsia endometrial
EP3827770A1 (fr) Tête de vidéocaméra endoscopique annexable à un protecteur de plaie chirurgicale, sans tube rigide ni fixation manuelle
US20100280368A1 (en) Trocar tube, Trocar, Obturator and/or Rectoscope for the Transluminal Endoscopic Surgery Via Natural Body Orifices
BRPI0903936A2 (pt) métodos e dispositivos para realizar gastroplastias utilizando dispositivo de acesso de orifìcio múltiplo
CN102215735B (zh) 手术内窥镜
ES2755473T3 (es) Módulo y aparato ginecológico
US20070270651A1 (en) Device and method for illuminating an in vivo site
US20170325798A1 (en) Wound retractor specimen bag
US20110160539A1 (en) Expandable member dissection port
US8080030B2 (en) Endoscopic sheath having a biomimetic retractor
CN109152585A (zh) 负压吸引鞘
CN103167824A (zh) 手术方法及设备
WO2007078003A1 (fr) Systeme medical a travers une ouverture naturelle ou transcutane
ES2964417T3 (es) Drenaje mediante esponja de vacío
JP2015085017A (ja) 内視鏡用トレーニング装置

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 15764378

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 15764378

Country of ref document: EP

Kind code of ref document: A1